Healthcare Provider Details

I. General information

NPI: 1255531190
Provider Name (Legal Business Name): MICHELLE MARIE KASCHINSKE OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W10133 SCHIEFELBEIN RD
POYNETTE WI
53955-8856
US

IV. Provider business mailing address

W10133 SCHIEFELBEIN RD
POYNETTE WI
53955-8856
US

V. Phone/Fax

Practice location:
  • Phone: 608-622-7815
  • Fax:
Mailing address:
  • Phone: 608-622-7815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number4418-026
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: